Scoring Necroinflammatory Activity in Chronic Hepatitis
Grade
Portal/periportal activity
Lobular activity
0
None or minimal
None
1
Portal inflammation
(CPH)
Inflammation but no
necrosis
2
Mild piecemeal necrosis
(mild CAH)
Focal necrosis or acidophilic
bodies
3
Moderate piecemeal necrosis
(moderate CAH)
Severe focal cell
damage
4
Severe piecemeal necrosis
(severe CAH)
Damage includes
bridging necrosis
Note: a score of 0 for portal activity
and 2, 3 or 4 for lobular hepatitis (CLH);
CPH - chronic persistent hepatitis; CAH - chronic active hepatitis; CLH -
chronic lobular hepatitis
Scoring Fibrosis and Cirrhosis
Grade
Fibrosis
0
None
1
Enlarged, fibrotic
portal tracts
2
Periportal or portal-portal
septa but intact architecture
3
Fibrosis with architectural
distortion but no obvious cirrhosis
4
Probable or definite
cirrhosis
Note:
alternatively, cirrhosis can be separately scored from fibrosis, into
the following categories: probably absent; developing; suspected;
present; cannot be assessed
Reference
Scheuer PJ. Classification of chronic viral hepatitis: a need for
reassessment. J Hepatol 1991;13:372-374.
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